摘要
目的探讨朝阳区社区卫生服务机构的信访原因,并提出预防处理对策,以避免医疗纠纷的发生。方法收集2014-09-01至2015-08-31朝阳区卫生信访服务中心"卫生信访信息管理平台"记录的信访件,对经查证属实或部分属实的投诉、举报、建议3类信访件进行分析;同时,通过朝阳区社区卫生服务管理中心记录数据,收集同期各社区卫生服务机构的工作量及医疗费用情况。采用Spearman秩相关分析信访量与年总工作量、人均工作量及次均费用的相关性,并比较不同财政补偿方式社区卫生服务机构的信访情况。结果共接收信访件534件,经查证属实或部分属实460件,查实率为86.1%。其中,反映药品问题120件(26.1%),反映医院管理问题91件(19.8%),反映服务态度问题57件(12.4%)。Spearman秩相关结果显示,信访量与年总工作量、人均工作量、次均费用均呈正相关(P<0.05)。25.6%(30/117)的财政统筹社区卫生服务机构受到信访,信访率为0.669×10^(-5);30.0%(18/60)的社管统筹社区卫生服务机构受到信访,信访率为0.753×10^(-5)。结论社区卫生服务机构存在的主要问题为药品、医院管理及服务态度问题;建议尽快统一社区卫生服务机构与大医院药品目录,制定并完善外带药品注射相关法规制度,增设社区卫生服务机构医务人员并加强管理,建立信访风险防范机制。
Objective To analyze the reasons of petitioning associated with community health services in Beijing Chaoyang District and put forward corresponding treatment measures, so as to prevent medical malpractices. Methods We analyzed the letters and calls of complaints,tip-offs and suggestions verified to be true or partially true among the petition cases recorded in the Health Petition Information Management Platform of Chaoyang District Health Petition Center from September 1,2014 to August 31,2015,and collected the data about the quantity of medical services and medical expenses of the community health service organizations（ CHSOs） recorded in Chaoyang District Health Petition Center during the same period. Spearman＇ s rank correlation coefficient was used to analyze the correlation of number of petition cases with total annual amount of medical services,per-capita quantity of medical services,and the cost of per patient medical care. And comparison was made in the status of health petitioning between the CHSOs with different financial compensation modes. Results Four hundred and sixty of the 534 petition cases were verified to be true or partially true with a verification rate of 86. 1%. Of them,26. 1%（ 120/460）were about drugs,19. 8%（ 91/460） were related to hospital management,12. 4%（ 57/460） were associated with service attitude. Spearman＇s rank correlation coefficient analysis found that,the number of petition cases had positive correlation with the total quantity of medical services annually,per capita quantity of medical services and the cost of per patient medical care（ P〈0. 05）. The percentage of CHSOs with the ＂ separate management of revenue and expenditure＂ financing mode complained was25. 6%（ 30/117）,with a complaint rate of 0. 669/100 000; the percentage of CHSOs with pooled social health insurance financing mode complained was 30. 0%（ 18/60）, with a complaint rate of 0. 753/100 000. Conclusion Main problems reflected in the petition events were issues of drugs,hos
作者
倪娜娜
刘宝花
白江梁
张莎
胡升星
白旭
吕春华
张巍
NI Na-na LIU Bao-hua BAI Jiang-liang ZHANG Sha HU Sheng-xing BAI Xu LYU Chun-hua ZHANG Wei(School of Public Health, Peking University, Beijing 100191, China Chaoyang District Health Petition Center, Beijing 100026, China)
出处
《中国全科医学》
CAS
北大核心
2017年第28期3477-3481,共5页
Chinese General Practice
关键词
社区卫生服务
卫生信访
北京
Community health services
Health petition
Beijing
